tribute trigger 1 Your contact detailsContact1Payment detailsPayment2Thank you!Thanks!3 Your donation amount * £ Every * - Select -month3 monthsyear Your reason for giving today (optional) Name of tribute Your contact detailsWe just need a few details before we process your donation. First name * Last name * Postcode * Must be a UK postcode. Address line 1 * Address line 2 (optional) Address line 3 (optional) Town or City * Country (if outside the United Kingdom) Phone number Email address This will help us if we need to contact you about your donation.By providing us with your contact details, you agree to our collection and use of this information as set out in our privacy policy.Gift AidWith Gift Aid your donation gives us an additional 25% Gift aid Yes, I want to Gift Aid my donations / subscriptions to Epilepsy Action, including any I make in the future, or have made in the past four years.* *I am a UK taxpayer and I understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.Please let us know if you want to cancel this declaration, change your name or home address or if you no longer pay enough tax on your income and/or capital gains. Leave this field blank
